Microneedling treatment

Microneedling Beware, this is how it can damage your skin in 2024

Primum Non Nocere. First, do no Harm.
It is the first rule of medicine; should we not extend this to skincare, too?

For those not deeply immersed in beauty trends, microneedling may be somewhat peculiar.

It is a cosmetic procedure that goes by various names such as dermarolling, derma stamping with PRF or PRP, and Morpheus 8,

It has a superstar status because of its purported benefits to the skin.

However, concerns and reported side effects have risen amid the buzz about its advantages.

So, for this article, I will delve into the intricacies of microneedling to understand where things can potentially go awry.

Are you keen to learn more? That’s great, because I dedicated a free ebook to it, which you can read here.

Before I proceed, it’s important to clarify that microneedling can produce excellent results when performed by experienced dermatologists or skilled skincare specialists.

However, challenges tend to emerge when microneedling crosses into the domain of at-home treatments or is performed by individuals in the industry who lack the necessary expertise.

In such cases, the potential side effects can span from scars, pocking, and infections to track marks, enlarged pores, and an expedited ageing process.

Some individuals have encountered complications like erythematous papules, alterations in skin pigmentation, permanent indentations, systemic hypersensitivity, and even the development of granulomatous dermatitis. There have been instances suggesting potential tumour formation and post-inflammatory hyperpigmentation.

With a career spanning over three decades as an experienced esthetician, I want to emphasise that my intention is not to promote fear or alarm.

However, it is impossible to disregard the weekly emails and comments we receive from our audience (see comment section) and these case studies, which vividly portray the physical and psychological trauma many have endured due to poorly executed microneedling treatments.

Therefore, this article aims to raise awareness regarding the potential risks linked to microneedling facial procedures, highlighting the complications that can arise so that you can be well-informed if you are contemplating having such a treatment.

What is microneedling 

Microneedling is a medical procedure that employs fine, sterile needles vibrating at high speeds. These needles puncture the skin’s surface with thousands of tiny holes in a few seconds.

These controlled micro-wounds are believed to stimulate a healing response in the skin, boosting collagen and elastin and developing new blood vessels in the dermis, the deeper layer of skin.

Healthy Skin Before Microneedling Damage Damaged Skin After Microneedling

In technical terms, it takes advantage of your skin’s response to any inflammatory wound.

For example, if you cut your skin, your body’s first line of defence is to deploy white blood cells; these release chemicals that increase the production of components that comprise your skin’s intercellular matrix.

They tell your body to patch the hole, creating new cells at the site of the wound.

A classical wound may be defined as a disruption of tissue integrity; any wounds, whether caused by injury or remodelling, rely on the biological phases of healing: inflammation, proliferation, and remodelling.

The Misconceptions

Many believe microneedling is a collagen-stimulating treatment that employs needles to injure the skin. This ultimately enhances collagen and elastin production and improves skin texture, pores, and fine lines.

Microneedling, in reality, penetrates the epidermis, your skin’s outer layer, creating minor puncture marks that disrupt your skin’s natural defence mechanisms. Consequently, your skin must work harder to repair these micro-tears through collagen induction, potentially leading to various skin issues.

That tightening sensation in your skin is inflammation and swelling. Breaking down your skin’s protective barrier with needles induces temporary trauma and injury, producing a plump, swollen skin effect. The often-described “lit-from-within” glow following microneedling is, in fact, a result of inflammation, which we believe can contribute to premature ageing.

Given the fact that there is trauma inflicted on your skin during this procedure, I hope you can appreciate why I emphasise the importance of choosing a skincare specialist with substantial experience in microneedling. It is essential to shop around before deciding on your treatment provider.

Why You Should Avoid Microneedling at Home

Cross-contamination is a significant concern with this treatment, mainly because the handpiece allows backflow. To minimise the risk of infection, microneedling should be performed in a sterile clinical environment by a skincare specialist experienced in this treatment.

Even a puncture as shallow as 0.2 mm can trigger an inflammatory response in your skin, potentially leading to issues at various depths. Moreover, at such depths, you’re introducing active serums to areas they aren’t meant to reach.

In summary, if your skin is compromised and showing signs like redness, dryness, inflammation, or acne-related issues, or if your skin is under stress, it becomes highly susceptible to damage, as demonstrated in this study (1).


Clemmy from London wrote: “I’m in dire need of assistance. My skin’s condition has worsened after microneedling at home. The treatment seemed to have torn apart my skin beneath the surface. My previously flawless skin is now in shambles, and I’m on the verge of tears. It’s lost its firmness and support, and I’m aware of the structural damage it’s sustained. I feel like I’ve been grazed all over. I’m too self-conscious to even step out of my house, and it’s been six months, yet my skin shows no signs of healing. I had absolutely no knowledge of the risks associated with microneedling

Nancy from Australia wrote: “I performed microneedling at home for the first time and i awoke to a swollen face and I had these scratch-like marks. IMy skin was irritated during the procedure, and that should have raised red flags. I also have some bruising. I went to clinic where they recommende I have a series of peels, which unfortunately triggered inflammation in my skin. Fast forward to today, and my skin is marked with tiny holes and lines. Thanks to the incredible support and products from your team, it’s gradually on the path to recovery. Nevertheless, it has been a time-consuming and strenuous journey, and looking back, I wish I had never ever done this to myself.”

Angela, a client, experienced the following: “I am 43 and I performed three micro needling treatment on myself which has left my face inflamed and I am battling severe facial burning. My once smooth skin is sensitive, and my pores are enlarged. I have been to a few dermatologists who have no idea what to do. Your advice is helping to rebuild my skin. I can’t thank you enough. I wish I had known about these microneedling side effects earlier.”

Marian from the USA wrote: “Micro rolling has destroyed my skin. After i performed the second treatment on myself I noticed bumps and holes in my face. It has dried out my skin and created strange horizontal lines I did not previously have; in short, microneedling at home is UNSAFE. Do not attempt it.”

Jen from Australia wrote: “After having 25 pages of blood tests, my dermatologist was very thorough, it been found that my condition is due to having a course of microneedling with PRP, treatments. I am devastated; my dermatologist believes I have solid facial oedema, which is very rare. I am now on Roaccutane & may need to be on it for 1-2 years; although my skin is responding, this will be a long battle to get rid of it. I’m completely shattered i had no idea i should not perform this treatment on myself. I would NEVER recommend micro-needling to anyone. I warn all my friends about the micro needling risks so they never suffer like I am. Your Xcell barrier repair skinshot  has been a lifesaver I refer to it as liquid gold.”

Thank you to those who openly shared your microneedling before and after the journey. I hope that together, we can help rebuild the health of your skin.

The following case studies (2) examined people who suffered facial allergic granulomatous reactions and hypersensitivity associated with microneedling treatment.

Side Effects of Microneedle Treatment

Reason #1: I have inflammation and rosacea

Chronic inflammation is highly damaging.

Microneedling is designed to create a certain level of inflammation, a natural response to the treatment’s trauma. This inflammation is generally considered a normal, physiological reaction that helps stimulate skin repair and rejuvenation. Most mild allergic or inflammatory responses should subside within a week.

However, if the inflammation persists, it might indicate that your immune system is reacting to a perceived foreign substance that it can’t eliminate. Chemicals, organic or inorganic materials, or bacterial infections could trigger this.

Initial redness and swelling may not be noticeable to the naked eye, which can be misleading. Prolonged inflammation that makes your skin sensitive to the touch can potentially harm the structural cells and matrix proteins in the deeper layers of your skin.

In some cases, persistent inflammation may lead to conditions like rosacea or granulomatous dermatoses, manifesting as inflammation and tissue distortion. These conditions can take weeks or even months to become apparent. This process is sometimes referred to in the industry as “skin flamm’ageing.”

Any plumping or firmness sensation during the initial stages is often just an illusion caused by the body’s inflammation response, leading to temporary swelling. Unfortunately, this inflammation can also lead to collagen breakdown, further accelerating the ageing process.

If you are concerned you have rosacea, we have created an entire resource you can read here.

Reason #2: My skin looks aged and sagging

When microneedles penetrate the deeper skin layer of the dermis, it triggers an inflammatory response that stimulates fibronectin production.

This glycoprotein acts as a scaffold for newly induced collagen, which tightens and smoothens the skin over time, reducing wrinkles and improving scar appearance.

However, the needle punctures mechanically damage the collagen fibres, desensitising the receptors responsible for signalling collagen synthesis.

This can lead to a paradoxical effect, where initial treatments succeed, but subsequent sessions have the opposite outcome.

Repeated collagen destruction through microneedling forces your body to produce more collagen fibres to replace what’s lost. Over time, this natural ability diminishes, accelerating the ageing process.

It’s crucial to understand that microneedling induces a stress response in the body. When your skin experiences this stressor, your body rapidly replenishes lost collagen.

While this might create the illusion of plumper skin, the damage to your skin’s internal scaffold can become apparent immediately or take years to manifest. The result is often lines, wrinkles, hollow areas, and sagging skin.

Furthermore, microneedling can damage healthy cells and disrupt their integrity, leading to cell death and an accelerated ageing process. Cellular turnover occurs when live skin cells replace old ones through cellular division.

During this process, the chromosome’s end in the cell’s nucleus, known as a telomere, is gradually cut off. Once approximately 60 divisions have occurred, the telomere is completely depleted, and ageing begins.

Microneedling accelerates the rate of cell division in your skin. The faster this occurs, the more rapidly your skin ages, resulting in sagging and the development of expression lines.

A note on fat loss in the cheek area

In the article “Understanding the Aging Face,” I discuss a study conducted by Oxford University (1), which proposes a significant insight into the dynamics of the ageing process in facial fat pads. According to this research, damage to the malar fat pad, responsible for the plumpness of the cheeks, is associated with specific types of movements.

The study suggests that horizontal movements may tighten the ligaments that anchor the malar fat pads in place, while vertical movements could have the opposite effect, potentially loosening these ligaments.

This finding offers a compelling explanation for experiences involving invasive microneedling procedures, where the machine is often dragged up and down, as well as certain hand facial exercises that entail up-and-down movements in this particular area of the face. These actions may inadvertently impact the integrity of the ligaments supporting the malar fat pads, contributing to undesired outcomes or complications.

Reason #3: My skin inflames when I apply products

Microneedling significantly disrupts your skin’s impermeable barrier function, composed of multiple layers of dead, keratinised cells that protect your deeper, living cells.

The needles create thousands of channels that allow topically applied substances to penetrate your skin.

However, until these channels form effective plugs and initiate healing, your skin remains exposed and vulnerable to anything it encounters.

This can lead to various concerns related to the treatment, often stemming from the topical solutions applied to the skin during maximal barrier function disruption.

Substances naturally occurring in your skin are generally safe, while those that do not should be avoided.

We recommend using “skin-identical hyaluronic acid” during the healing stage and, once healed, transitioning to a formula containing ceramides, lipids, cholesterol, and fatty acids.

We’ve detailed what happens when you micro-needle specific ingredients into your skin in a dedicated article, which you can read here.

Reason #4: My skin has an orange-peel texture

Microneedling creates hundreds to thousands of puncture holes in your skin, not visible to the naked eye but large enough to serve as pathways to your bloodstream.

Your skin interprets this as trauma, causing your sebaceous glands to become overactive and your skin to become excessively oily.

The increased oil production can lead to clogged pores, breakouts, and an uneven, orange-peel-like texture akin to cellulite. These textural changes are often associated with low-grade inflammation resulting from microneedling.

Another reason skin develops an orange peel texture is cellulitis, a condition caused by bacterial infection of open skin. It can cause skin to become pitted, swollen, red, and tender.

Bacteria cause cellulitis, which oral antibiotics can treat. However, it is a severe infection, so do see a dermatologist if this sounds like you.

Other issues may include the development of raised, milia-like bumps, blackheads, and enlarged pores.

Reason #5: Horizontal track marks have appeared

Many clients who come to us after microneedling at home wonder if this is a typical side effect, and here’s the detailed answer:

If, like many well-trained estheticians and dermatologists, you are skilled, gentle, and adept at handling the microneedling device, this damage would not occur.

This tracking is due to “operator error” when excessive pressure is applied over the bony areas of the face with the hand-held device. This can result in bruising and tram-track scarring.

Interestingly, a study by Yadav and Dogra (3) also attributed this finding to nickel-contact dermatitis.

Reason#6. I have developed dark patches

Skin trauma can stimulate the production of melanin, the pigment responsible for changes in skin colour. This pigment accumulates at the site of injury and results in hyperpigmentation.

Individuals with darker skin types, typically classified as type 3 or higher on the Fitzpatrick scale, are more susceptible to hyperpigmentation in response to inflammation.

Experienced skincare specialists will assess their clients’ skin on the Fitzpatrick scale.

If you are not experienced in this treatment and have performed it on yourself, you can cause these pigmentation changes, which highlights the importance of not performing this treatment on yourself.

Follow the link to find out more about inflammatory hyperpigmentation.

Reason # 7. Potential tumour formation

Reason #7: Potential Tumor Formation

In the past, it was believed that old skin wounds were benign. However, recent research (4) has shed light on the connection between skin wounds and basal cell carcinoma, the most common type of skin cancer.

Basal cell carcinoma originates in the basal cell layer, which is the lower part of the epidermis and the cells of hair follicles.

Tumour formation occurs when errors in the DNA of follicular cells lead to unregulated cell division, which results in tumour growth.

It is now understood that a wide range of wound-type injuries, even minor ones like paper cuts, can activate genes in your skin that are linked to the development of cancer as the skin heals.

Research by Reiter & Wong (5) has shown that skin wounds may promote the development of basal cell carcinoma. Hair follicle stem cells can transform into cancerous cells while healing an injury.

Reiter and wong state that scientists believe cancers are wounds gone awry. Usually, the hair follicle represses the tumour-generating potential of the stem cells, he says, but when these cells become unstable, trouble begins.

The significant finding here is that the development of basal cell carcinomas is not limited to large wounds; even minor incisions, such as those created by micro-needling, could potentially induce carcinomas.

Micro-needling causes tiny wounds in the skin, mobilising cells from the hair follicles to heal these injuries. The mobilisation of these cells into the epidermis, the outer layer of skin, can contribute to the formation of tumours.

Caring for your damaged skin after microneedling

This is paramount to preventing infection and scarring; the sooner, the better. Recovery is possible, but the timeline may vary based on the extent of the damage and your skin’s response to treatment.

While some individuals experience healing within 6 to 12 weeks, aligning with the skin’s natural cellular turnover, others may require a more extended recovery period. The proper treatment protocol and appropriate skincare ingredients are essential to effective healing.

Our skincare philosophy emphasises simplicity and purity when tending to post-micro needling skin damage.

We recommend adhering to a consistent skincare regimen incorporating gentle, barrier-repairing topicals.

It’s essential to minimise inflammation within your skin during the healing process, so we suggest avoiding using active ingredients like Vitamin C and A until your skin’s barrier function is restored and the healing process is underway.

It’s worth noting that certain complications, such as granulomatous reactions, have been reported in individuals who used unauthorised topical products that were not approved for intradermal injection during microneedling procedures.

These issues highlight the importance of proper care and guidance in post-treatment skincare.

To Conclude. The naked truth

In summary, microneedling can work wonders in the hands of experienced professionals, but it’s a different story when attempted at home or by those lacking expertise.

The potential downsides are no small matter, ranging from scars and infections to track marks, enlarged pores, and even the acceleration of ageing.

Some clients have experienced significant problems like skin discolouration and hypersensitivity, and there’s even a potential link to tumour formation. So, if you’re thinking about microneedling, ensure you’re well-informed and exercise extra caution with at-home procedures.

Because microneedling is a treatment that uses tiny, sterile needles to create micro-injuries in the skin, one big concern is the risk of cross-contamination, so professional, sterile settings are a must to avoid infections.

It’s also vital to know that even shallow punctures can cause inflammation and deliver products too deeply into the skin, especially if your skin is already sensitive.

Ultimately, deciding whether to undergo a microneedling treatment should be carefully weighed up; your skin is your body’s largest organ and deserves thoughtful attention.

If you’re worried about your skin’s health and recovery post-microneedling, please contact us here with photos for personalised evaluation and guidance.

Our priority is your skin’s well-being, and we’re here to support you on your path to recovery.

(Disclaimer: This information is for educational purposes and not a substitute for medical advice. Consult a healthcare professional for personalised recommendations.)


  1. Unintended widespread facial autoinoculation of varicella by home microneedling roller device.

  2. Facial Allergic Granulomatous Reaction and Systemic Hypersensitivity Associated With Microneedle Therapy for Skin Rejuvenation.

  3. A Cutaneous Reaction to Microneedling for Postacne Scarring Caused by Nickel Hypersensitivity.
  4. Previous injuries or scars are risk factors for basal cell carcinoma development.
  5. Mutant stem cells can cause skin cancer at cuts.

  6. Facial allergic granulomatous reaction and systemic hypersensitivity associated with microneedle therapy for skin rejuvenation.

464 replies on “Microneedling Beware, this is how it can damage your skin in 2024”

Hi Samantha,

Thank you for such an informative article. When it comes to skin aging is this just a side effect if micro needling isn’t done correctly? If a professional was performing this procedure and did everything right would this still be a side effect?

Emily its a double edged sword. Please check the comments to find out more. We get around 5 emails week from people where their skin ageing is actually made worse along with other skin concerns.

Hello, thank you for this fantastically detailed information! However, I do have a question, your article focuses on the dangers of attempting home procedures, but the with the information given, it sounds to me like the same dangers exist even for professional applications (in the sense that it is still trauma to the skin in thousands of micro punctures). Reasons #1, 2, 3, and 7 would all still be present for professional applications. The only difference it seems would be that a professional could warn you away from microneedling if there could be immediate adverse reactions and that they have the skills to use the tools properly and in a sterile environment. The damages to your skin long-term, ultimately, is still present. Am I misunderstanding anything? If that is there case, do you recommend microderm abrasion or chemical peels as a more safe alternative? Or other alternatives?

Hi Angie. the dangers still apply for inclinic yes, but one would hope that the clinician is experienced enough to avoid such side effects, but we appreciate this is sadly not always the case.

Hello Samantha, thank you very much, I highly appreciate your informative blog. What Is your opinion on nano microneedling at home, can this procedure also be risky in any way? Thank you for your response, best regards Magda

Hi Magdalena no problem at all, were writing these article not to scare monger but to try to educate people about the potential dangers. Personally I would not be comfortable recommending you do microneedling at home, this is where we see a lot of the problems especially around sanitisation and infection.

Hello, I did microneedling 12 weeks ago and my skin still hasn’t healed. It has left holes in my pores, and some track marks, and parts of my face look like they’re starting to sag a bit. I’m so defeated, what can I do? Are these things permanent?

Hello I had micro needling done and it ruined my skin. It left me with hyper pigmentation patches on my cheeks. What can I do to fix this? Thank you, I appreciate your help.

What are your thoughts on the Skin Pen? My Dr’s office offers it, and even suggested it… I am 62 yrs old and don’t want to experience what I have seen by your correspondents have!!
Thank you!

Hi Linda. Like all of these procedures they work for some and not other. We recommend doing your research well and getting a very experienced therapist or dermatologist to perform your treatment.

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